Classics in abdominal imaging: the dependent viscera sign

Excerpt

The dependent viscera sign on CT scan refers to hollow and solid organs lying in a dependent position against the posterior thoracic wall, with obliteration of the posterior costophrenic recess, in patients with diaphragmatic rupture. Blunt abdominal trauma usually is the cause [1], and it can involve either hemidiaphragm [2]. In the pre-CT era, preoperative diagnosis of diaphragmatic rupture was problematic, not only because of non-specific or absent clinical signs, but also the relatively low sensitivity of chest radiographs for detecting the injury [1]. With the advent of multidetector CT for evaluating blunt trauma, the ability to detect diaphragmatic rupture prior to surgery has increased dramatically [2, 3] (Fig. 1).

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